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DESCRIPTION

Bursitis is an inflammation of a bursa and occurs when the bursae becomes irritated and
swollen. The bursae are small fluid-filled sacs located between tendons and bone in various
places in the body, particularly near joints. They help to promote muscular movement by
cushioning against movement friction between bones, tendons, and ligaments. By reducing
friction, each of the more than 150 bursae in your body helps the joints operate smoothly
through the full range of natural movement.

The bursae in the hip and shoulder joints are most often affected since the shoulder has
the greatest range of motion in the body. Bursitis is prone to affect the elbows, knees, feet,
and the base of the thumb, as well.

Epicondylitis or epitrochlear bursitis, affecting the arm is often called "tennis
elbow" or "frozen shoulder." Tennis elbow may start as a small tear in the tendon, and is more
likely to occur in people whose jobs require repeated tight gripping of an object.
Occupational bursitis is not uncommon, and is known by old, familiar names such as "housemaid's
knee," "policeman's heel," or the "beat knee" or "beat shoulder" of coal miners.

Trochanteric bursitis is inflammation of the bursa in the hip. This may be caused by continual
physical activity, by standing for a long time, or by a displacement of the hip. An aching
pain that may radiate down the leg normally accompanies it. One of the most common foot ailments,
the bunion, is actually a form of bursitis caused by friction; a tight-fitting shoe causes
a sac on the joint of the big toe to become inflamed.

It can sometimes be difficult to differentiate
between bursitis and tendonitis, the inflammation of a tendon. Tendonitis is closely related
to bursitis, and the two are often confused. Bursitis is usually characterized by a dull,
persistent ache that increases with movement, whereas tendonitis, which is the inflammation of
the tendons caused by strain, typically causes sharp pain on movement. Tendonitis often
afflicts people who routinely have to reach to perform certain activities, such as domestic workers
and painters. Tendonitis is most commonly found in the shoulders, hips, Achilles tendons, or
hamstrings. Tendon inflammation may also result from calcium deposits that press against a tendon.
Unlike tendonitis, bursitis is often accompanied by swelling and fluid accumulation.

Bursitis can affect anyone, at any age. However, older people, especially athletes, are
more likely than others to get bursitis. Bursitis is usually characterized by a dull, persistent
ache that increases with movement, and rotation of the arm may be difficult if it is in the shoulder.
This condition is often worse at night, and the pain usually extends from the top of the
shoulder to just under the large shoulder muscle of the back.

The discomfort of bursitis tends to be most severe after a night's sleep and will typically
subside somewhat with normal activity.

SYMPTOMS

Stretching or extension when exercising, lifting, or otherwise pushing the joint beyond
its normal limits, an inflamed bursa in the shoulders, elbows, hips, knees, or joints of
the hands or feet:

Causes pain.

Tenderness to the touch of the affected body part.

Limitation of motion, with or without immediate pain.

Loss of motion, especially affecting the shoulder.

Redness.

Swelling and inflammation.

Muscle weakness.

RISK INCREASES WITH

Manual Workers: Heavy lifting, repetitive motion or working for extended periods can
strain the joints and bring on a bursitis attack.

Athletes: They get bursitis after running, throwing, or jumping, or from making aggressive
arm swings in tennis, baseball, and even bowling.

Usually Sedentary People that occasionally are active: When they tend to push themselves
and their bodies past reasonable limits, they are at risk for bursitis.

CAUSES

A bursa can become inflamed and the sac fills with excess fluid, causing pain, tenderness to the
touch of the affected body part, and limitation of motion as well as pressure on surrounding tissue when:

Caused by injury.

Chronic overuse, or when it remains under pressure for a long time.

Reactions to certain foods.

Airborne allergies.

Calcium deposits.

Tight muscles also may lead to bursitis.

Calcified bursitis occurs when scar tissue develops in the bursa because an original injury was left
untreated. The bursae in the hip and shoulder joints are most often affected.

TREATMENT

DIAGNOSIS & MEDICATIONS

An x-ray of the affected area may be taken to look for bony spurs (abnormal areas) or arthritis.

Aspiration, in which fluid is taken from the swollen bursa and evaluated under a microscope, to rule out gout or infection.

Blood tests to screen for conditions such as rheumatoid arthritis or diabetes.

A magnetic resonance imaging test (MRI) also may be performed to evaluate your condition.

Initial treatment typically consists of aspirin or other over-the-counter non-steroidal
anti-inflammatory drugs (NSAIDs). These pain relievers also tend to reduce inflammation. An
injection of a local anesthetic mixed with one or more cortisone preparations into the
bursa may be recommended to decrease inflammation and reduce pain. Heat and ultrasound can
help relax the joint and promote tissue repair.

Diathermy (deep-heat therapy), under the direction of a sports health care provider,
licensed physical therapist, or trainer, not only can relieve the discomfort and
inflammation of bursitis but also can soothe tense muscles, nerves, and tendons. It may
help to apply ice to the affected area for 20 to 30 minutes twice daily for 2 or 3 days.

In cases when bursitis may recur, your health care provider may prescribe corticosteroid treatment,
in the form of either oral medication, topical creams, or injections to the affected joints. In severe
cases, it may be necessary to draw fluid from inflamed and swollen bursae with a needle to relieve the
pressure. In persistent conditions, bursae can be surgically removed.

PREVENTION

Warming up before strenuous exercise and cooling down afterward is the most effective way
to avoid bursitis and other strains affecting the bones, muscles, and ligaments.

Avoid activities that aggravate the problem.

Rest the affected area after activity.

EXPECTED OUTCOME

Although bursitis generally disappears in a few days or weeks, you must take
measures to avoid further strain or injury. A physical therapy program that includes
stretching and focused strengthening exercises could be helpful.

Bursitis may recur, particularly if you engage regularly in strenuous exercise or physical labor.

COMPLICATIONS

Some people may be tempted to ride out the pain, but this is not recommended. Without
treatment, chronic bursitis can lead to the formation of calcium deposits in normally soft
tissues, sometimes causing permanent reduction of motion in the affected joint.

To relieve pain, use hot castor oil packs. Place castor oil in a pan and heat but
do not boil it. Dip a piece of cheesecloth or other white cotton material into the oil
until the cloth is saturated. Apply the cloth to the affected area and cover it with a
piece of plastic that is larger in size than the cotton cloth. Place a heating pad over
the plastic and use it to keep the pack warm. Keep the pack in place for one-half to two
hours, as needed. Some health care providers recommend ice packs.

You may need to abstain from activity and get plenty of rest. When engaging in
physical activity, do not push yourself too hard or too long. If you are in pain, stop.

Treatment for bursitis involves removing the cause of the injury (this usually means rest
and/or immobilization of the affected area), clearing up any underlying infection, and
possibly surgically removing calcium deposits.

Applied topically, dimethylsulfoxide (DMSO), a byproduct of wood processing, can
relieve pain and reduce swelling. Note: Only DMSO from a health food store should be
used for healing purposes. Commercial grade DMSO found in hardware stores is not suitable.
The use of DMSO may result in a garlicky body odor. This is temporary, and is not a cause for concern.

A new, still experimental, treatment for bursitis involves injecting honeybee venom
directly at the site. The venom contains a powerful anti-inflammatory and can provide rapid
relief. It can be injected either with a hypodermic needle or by the bees themselves. Further
information is available from the American Apitherapy Society in Hartland Four Corners,
Vermont; Tel: (802) 436-2708.

HERBS

Horsetail extract supplies silica, a form of the trace mineral silicon, which is necessary
for tissue repair and healing.

Unless otherwise specified, the following recommended doses are for adults over the age of 18. For a
child between 12 and 17 years, reduce the dose to 3/4 the recommended dose. For a child between 6 and
12 years old, use 1/2 the recommended dose, and for a child under 6, use 1/4 the recommended dose. See
Bursitis Supplements & Products for more helpful
recommendations.

This unique Calcium Magnesium Zinc Supplement formula perfectly balances calcium, magnesium,
and zinc with over 70 minerals and trace elements found in ConcenTrace for maximum absorption and
utilization by the body.

Numerous scientific studies show glucosamine sulfate to be highly effective. An advancement
over competitive brands, FlexMax glucosamine sulfate is non-irritating to the stomach because
of its proprietary StomachGuard technology that utilizes plant fibers to form a protective
gel around the tablet upon entering the digestive tract.

Used to treat bursitis, tendonitis, headaches, osteoarthritis, dysmenorrhea, rheumatoid
arthritis, back pain, toothache, and menstrual cramps, White Willow is being used by more
people as a safer, natural alternative to aspirin.

This extra strength formula is said to be 100 times more effective than Cat's Claw. Samento is
beneficial in the treatment of a wide range of immune system related conditions; these include
but are not limited to cancer, arthritis, bursitis, rheumatism, allergies, ulcers, systemic
candidiasis, all forms of herpes, diabetes, lupus, chronic fatigue syndrome, intestinal disorders
and HIV infection.

White Willow bark (Salix alba) was the basis for the synthesis of aspirin. It contains
salicin and related compounds. It has been used for more than 2,000 years to relieve aches and
pains of all sorts.

WaterOz Ionic Zinc is a pure liquid Zinc supplement. Zinc moves through all the fluids in the
body, it creates a defense against infection-causing bacteria and viruses trying to enter the
body and stops bacterial and viral replication.

Nature's Way Zinc lozenge boosts cold season defense with zinc, widely recognized as an important
nutritional support during the cold season, and echinacea pupurea, clinically shown to support the
immune system, and Vitamin C, a vitally important vitamin for general health maintenance.

Pain in a joint persists more than a few days; you may be experiencing tendonitis, a
strained ligament or tendon, or the onset of arthritis.

You are unable to move the affected area.

Swelling persists after taking medication of pain or an anti-inflammatory agent as
prescribed. You may need to have your health care provider drain fluid from the affected
joint, or you may need steroid injections into the joint to decrease inflammation.

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